Health Insurance
In Germany, health insurance (Krankenversicherung) is mandatory by law for all residents. The system ensures that everyone has access to healthcare, whether through public (gesetzliche Krankenversicherung, GKV) or private (private Krankenversicherung, PKV) insurance.
Public vs Private Health Insurance.
Most Germans opt for GKV due to its affordability and family benefits, while PKV is attractive for young, healthy professionals who can secure lower premiums and better services.
Keep in mind that switching from GKV to PKV is possible but returning to GKV later can be difficult.
Public Health Insurance (GKV).
Covers around 90% of German residents.
Open to employees earning under €69,300/year (as of 2024), students, pensioners, and unemployed individuals.
Funded through income-based contributions (14.6% of gross salary + additional contribution, split between employer and employee).
Geographical cover in Germany and basic cover the EU
Family members (spouse and children) can be insured for free under one policy.
Insurance pays doctors directly, no payments required from you.
NOTE: small additional fees are possible, e.g. staying overnight at the hospital.
Standardised benefits, including doctor visits, hospital stays, and medications.
Private Health Insurance (PKV).
Premiums are based on age, health status, and coverage level, not income.
Available to self-employed individuals, civil servants, and high-earning employees (earning above €69,300/year).
International cover is possible, however, it is dependant on your insurance policy.
No free family coverage—each person needs their own policy.
You pay for the treatments yourself and request reimbursement from the insurance company.
Offers more flexibility and “better” services, like shorter wait times and access to private doctors/hospitals and specialists.
That being said, with GKV you are still able to receive the same care as those with PKV. It just depends on which practitioner you visit.
Which applies to me?
Pflichtversichert (Compulsory Insurance).
As a young person studying or just entering the job market in Germany, through Ausbildung or Duales Studium, you are more than likely Pflichtversichert.
Being Pflichtversichert requires you to enroll in a GKV
You are Pflichtversichert if you fall under the following:
Studying:
Students pay their insurance contributions every Semester, as opposed to monthly.
Earn a yearly income below €69,300:
Your employer deducts your contributions from your BRUTTO (income before tax) salary.
Freiwillig Versichert (Voluntary Insurance)
Although this would not really apply to a young person moving to Germany, it is still important to know the difference between the different forms of insurance
Most people in Germany are Pflichtversichert, while high earners and certain self-employed individuals have the choice between freely staying in GKV or switching to private health insurance (PKV). This is what is meant by Voluntary insurance.
Applies to employees who earn above €69,300/year but choose to stay in GKV instead of switching to private insurance (PKV).
Also includes those who lose their Pflichtversicherung status (e.g., after job loss or moving from employment to self-employment) but still wish to remain in GKV.
Contributions are still income-based, but calculated from total income (including rent, investments, etc.), making it sometimes more expensive than Pflichtversicherung.
How to apply for health insurance.
Normally it is only possible to apply for German health insurance when you are in Germany and completed your Anmeldung.
But health insurance in Germany is mandatory, how am I supposed to get into the country when my S.A. health insurance is not accepted?
Before you apply for your visa, you should take out travel insurance for at least 3 months. This should be enough time to do your Anmeldung and apply for a GKV in Germany
You can apply online or at a local branch.
The recommendation is for newcomers to be insured with a provider, that has a physical branch that you are able to visit and have your queries done with someone face-to-face.
This is the most straightforward way to apply for health insurance in Germany.
Universities and Digital notice.
Incoming students have a special case when it comes to applying for health insurance in Germany.
Majority of universities in Germany require a digital notification from a German public health insurance provider, BEFORE you can be enrolled at the University.
More than likely you can still apply to your university of choice, and you may even be accepted. But if this digital notice is not sent out to the university, from the insurance company, then you cannot be enrolled.
This might seem confusing at first, given the “normal” way of applying for health insurance above, but there are ways to acquire the digital notification from South Africa.
Contact German health insurance companies from South Africa and mention that you have admission and will be studying at a particular University in Germany.
Mention that you need the digital notification.
You should receive a “Vorläufige Dokument” Preliminary document, stating that you have applied for a GKV at the health insurance company and that a digital notification has been sent out to the university.
BEWARE of contacting multiple insurance companies. We will soon recommend good health insurance companies that you can get in touch with, but the bottom line is that you should limit the amount of health insurers you approach (if not keep it to just one insurer).
The problem is that a lot of international students use this method of contacting insurers in order to get the digital notification. So insurance companies generate Vorläufige Dokumente without giving you confirmation that they’ve actually done so. You could have sent them an email or applied online… they will still do this.
This means that the more insurance companies you apply to, the more digital notifications get sent to the universities on your behalf. WHICH IS A PROBLEM.
Universities will view multiple digital confirmations as an anomaly or fraud and will not allow you to be enrolled. So be careful!
When you arrive in Germany, and after your Anmeldung, you should make the health insurance company aware that you have arrived. This is so that they can send the necessary documents that shows how much you need to pay for the semester and into which account.
Ask if your blocked-account’s partner health insurer (if applicable) has already sent out the digital confirmation to the university.
If not the case, message the partner health insurer and ask them to send it.
Duales Studium and Ausbildung.
Duales Studium.
Since you are studying and working at the same time it may be that you still need the digital notification in order to be enrolled at your university.
If that is the case, you can either:
Follow the steps mentioned above for students.
Or get in touch with your HR department and ask them to organise the health insurance for you and the the insurance company should send the digital notification.
Your dual study partner company, will more than likely have a “go-to” health insurance provider for all their employees
As a student that is working in tandem with their studies, and due to your fixed income, you do not have to stress about having to pay the health insurance yourself.
Your company will pay this for you from your BRUTTO (Income before tax).
Ausbildung.
For those of you who are going to be doing a Ausbildung, you don’t have to worry about digital notifications to universities.
You can do the following:
Take out your 3 months travel insurance prior to arriving in Germany (and your visa appointment) and complete your Anmeldung. Once that is done, get in touch with your HR department and ask them to put you on their health insurance plan.
If your company does not have a partner health insurance provider, then simply apply for GKV online or preferable at a local branch.
As a young person pursuing a Ausbilding (Apprenticeship), and have a fixed monthly income, you do not have to pay the health insurance yourself.
Insurer Recommendations.
Dr-Walter
Dr-Walter offers a variety of health insurance packages, most notably private and public health insurance.
GKV with Dr-Walter
In Partnership with TK (Techniker Krankenkasse), Dr-Walter gives South Africans the option to apply for German health insurance from within S.A.
Meaning that incoming students are able to easily receive the digital notification, by just filling out the application form on their website.
Barmer
Barmer is one of the largest public health insurance providers in Germany, offering GKV to students as well.
GKV with Barmer
Like Dr-Walter and TK, Barmer allows South Africans to apply from S.A. through an online application portal, making it easier for students to receive the digital notification.